One lesson from the workforce study is that time-consuming calls and paperwork, including prior authorizations and dealing with formulary restrictions, create hurdles that rheumatology clinicians must overcome daily. This cuts into their time to provide care and makes it harder to maximize staff resources.
Burdensome school debt may cause some medical students and residents to choose more lucrative specialties like orthopedic surgery or cardiology, says Dr. Battafarano. Health professionals could ease the burden, but “if you’re going to train a nurse practitioner or physician assistant in rheumatology, how will you do that effectively? The ARHP does have some online training modules, but we don’t have one formal training program in the U.S. now. Not one.”
Regional distribution of rheumatology care providers is also uneven. More than 20% of rheumatologists work in the Northeast, but the Southwest and Northwest each have less than 5%.
Strategy Needed
“There are regions of the country where patients have significant difficulty obtaining rheumatologic care. We will need to come up with innovative strategies to improve access to care,” says Dr. Monrad.
Recruiting future rheumatologists while still in medical school is a major, ongoing effort for the ACR, such as their Choose Rheumatology campaign, she notes.
“Addressing barriers to choosing rheumatology as a career, along with providing support to rheumatology professionals in both academic and non-academic settings, will enhance our ability to recruit and retain our future workforce,” says Dr. Monrad.
Data sources for the study included white papers, position papers, government and Institute of Medicine reports, and four online questionnaires sent to primary rheumatology providers, health professionals, fellows in training, adult patients and parents of pediatric patients.
Susan Bernstein is a freelance medical journalist based in Atlanta.
